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Individual

DR. ALAN PETROSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1264 WYOMING AVE, FORTY FORT, PA 18704-4138
(570) 288-8795
(570) 718-1786
Mailing address
36 COSLETT LN, HUNLOCK CREEK, PA 18621-4014
(570) 477-5608
(570) 477-5542

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS008935L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0853152
OH
Enumeration date
11/26/2005
Last updated
08/14/2012
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